On Tuesday evening, June 18, the Navigating the Medical System Lecture Series featured Dr. Mel Breite, Director and Founder of the series, for the end-of-year virtual lecture, hosted by Congregation Etz Chaim.
Dr. Breite shared the latest medical news and, as always, shared his sage medical advice with the community. He began by explaining significant changes in the way medical care is delivered. In the past, employees paid insurance for hospitals only. Now insurance companies allow for a yearly free physical. Dr. Breite advised you to make sure when you schedule it that it’s a full 365 days since your last physical. He shared that Medicare also covers this. Most medical insurances also cover medicines for 90 days. Every insurance company has a different formulary. He pointed out that you need prior approval for non-generic medications because they are more expensive. Prior approval is needed for most imaging.
He cautioned that there are illegal medical scams going on, and you need to be wary. Beware of unnecessary consultations. Stay away from Dr. Google. There are even fake studies cited in academic journals.
Private hospitals are taken over by five large ones in New York. The five are NewYork-Presbyterian, Mt. Sinai, Montefiore-Einstein, Northwell, and NYU Langone. He said to avoid any hospital not connected to these five.
He said that in the next five years you will be seen by physician assistants or nurse practitioners. Specialists will be Dr. AI. Also, there will be more tele-visits as opposed to in-person. You’ll be seen more by physical therapists and occupational therapists.
He noted that fewer adults are seeking vaccinations since the Covid vaccine, which is not a good thing. Also, more people are setting up appointments and then not showing up. This is frustrating for physicians as it means someone else is losing out on receiving care. Be sure to call to cancel if you can’t make it to an appointment.
During the pandemic, people became accustomed to receiving refills for medications over the phone. This is not good practice, as a patient should be seen by a physician to check on cholesterol levels, blood pressure, etc. before receiving refills. Dr. Breite elaborated on this. He said, “How often to see the physician in person depends on the patient’s condition. Every three months is typical, but it may be one or six months for certain things. What really should happen is the doctor should tell the patient to make an appointment on the way out for a certain number of weeks or months for follow up, so that the appointment is in the book.” He emphasized, “Please make that appointment.”
Next, Dr. Breite spoke about vaccines. He shared that he receives the flu vaccine every year and has done so since he was 21. He strongly recommends the yearly flu shot. In terms of the pneumonia shot, he says that the new pneumonia vaccine treats aggressive pneumonias.
He strongly recommends the shingles vaccine for people over age 50. Medicare pays for it and it’s worth getting.
He is not happy with the RSV vaccine. People get sick from it, and it hasn’t been proven effective. It’s a new vaccine.
He said that Covid mimics the flu, so there are many strains, and he can’t give a full opinion on the Covid vaccine.
Next, he spoke about GI medicine. He recommends a colonoscopy every ten years up to age 75. There is another test called Cologuard, but it has ten percent false negatives.
He noted that there is a lot of research now on gut flora. There is research on certain gut flora being conducive to certain medical conditions.
Next, he shared interesting studies. In one study in China some participants were given a sweet drink, and others were not, and then they were tested to see who had more irregular heartbeats. The group who drank the sweet drinks had more irregular heartbeats.
There was also a study to research a connection between Covid and rheumatic disease. So far, their conclusion is that there is no connection.
Another study linked cleaning products to asthma and wheezing. Another study on multivitamins found that there was no evidence that they preserve your brain.
Next, Dr. Breite shared advice on how to prevent falls. When lying down and then standing, your blood pressure drops, so you should sit up for at least ten seconds first. Also, have something nearby to grab onto before standing or if you feel dizzy.
Following this, he spoke about eight factors in cognitive problems. The list includes smoking, elevated blood pressure, poor sleep, medications, depression, diabetes, inactivity, and social isolation.
He spoke also about diet and recommended the Mediterranean diet as a healthful diet. Avoid processed foods. These lead to anxiety, diabetes, heart disease, and high blood pressure.
Stick a fruit bowl on the table for snacking. Normal blood pressure is 130/80.
He said that PSA testing is controversial. The bottom line is that MRI tests are better than the biopsy option for screening prostate.
Most people die from cardiovascular disease, so checking blood pressure is important. You can purchase a home blood pressure machine to track your blood pressure. Lowering blood pressure prevents strokes.
He cited a study that showed that men on statins after three years had 30 percent lower incidence of strokes. The message is clear. If your cholesterol is high, go on a diet. Lose weight. Cut down on sugars and starches and control your blood pressure.
Dr. Breite shared that he is already planning lectures for next year.
Rabbi Moshe Rosenberg, Rav of Congregation Etz Chaim, thanked Dr. Breite for this informative, wonderful lecture series that has been adding to and continues to add to the health of our community for the past 13 years. Thank you, Dr. Breite!
By Susie Garber
